Don't tell me my pain is all in my head

Psychosomatic Back Pain

A search on Google brings up the following definition:

“Psychosomatic disorder is a psychological condition that leads to physical symptoms, often without any medical explanation. It can affect almost any part of the body. People with the disorder tend to seek frequent medical attention, becoming frustrated with no diagnosis. Behavioral therapy and stress reduction may help.”

This does not help anyone understand what is going on nor give any sensible guidelines for treatment.


Can thoughts alone be the cause of back pain?  If so, is physical therapy really necessary?

Yes and YES!

And behind both answers lay the reasoning behind my new back care programme BODY MIND BACK.

To help explain what makes this programme unique, I’d like to share a little about how it evolved, and why it’s important for those who suffer from back pain.


Yellow Flags

Sometime during the middle of my career as a musculoskeletal-specialist physiotherapist, the assessment process of a patient was updated to include specific questions that sought to determine psychological, social, and environmental risk factors.

The idea was to help us be able to highlight obstacles to recovery – to identify patients who may not get better as “per the norm” for their condition, and those who were at risk of developing chronic disability.

In theory, these psychosocial yellow flags were designed to give a better framework for assessment and planning.

In reality, as with many such guidelines, their impact on clinical practice is unclear, and an article published in 2011 states that some authors have criticised the definition of psychosocial risk factors so broad as to be “meaningless”.

From a practical point of view, I remember feeling uncomfortable asking questions such as:

What do you understand is the cause of your back pain?

What are you expecting will help you?

How is your employer responding to your back pain? Your family?

What are you doing to cope with back pain?

Do you think that you will return to work?

I felt I had not the skills necessary to frame the questions in a constructive manner. The same goes for how to receive what came back. Even when someone answered, “no, I don’t think I will get back to work,” I was expected only to document it.

The whole “culture” of the process made me begin to doubt the validity of what my patients were telling me. It was not uncommon to hear physiotherapists and GPs assess their patients as “swinging the lead”.  Also, the lack of follow-through made me feel that I was failing my patients on several counts:

  • I felt I had not the skills required to support my clients from a biopsychosocial point of view;
  • I was unable to refer the patient to a more appropriate specialist. The head of the department said that GPs had almost no budget for patients to see psychologists and until that changed, we would have to continue mopping up the problem!


Body Mind Backs

A Holistic Approach to Back Pain Relief and Spinal Health Based on Physical Therapy, Yoga and Lifestyle Prescriptions®

Underpinning Lifestyle Prescriptions® is Organ-Mind-Brain Anatomy (OMBA). This evidence-based health coaching model details the connections between biological stress, unresolved emotions, habitual-limiting beliefs, social conflict situations, lifestyle habits, and their effect on specific organ tissues.

By its very nature then Lifestyle Prescriptions® offers a biopsychosocial method of assessment and with root-cause analysis at its core, a means of treatment. 

We are able to see very clearly how a single thought/emotion causes chemical reactions that lead to physical changes in our body. Specific thoughts then can and do lead to tissue changes of the bony spine itself, the intervertebral discs, the muscles, ligaments, tendons, and nerves.

Tissue-breakdown and inflammatory processes such as heat and swelling are an integral part of this process.

When we change our thoughts, the tissues likewise respond.

Introducing physical exercises at any point along the way can be used both as a means of evaluation and enhance repair. This is why physical movement is an important aspect of the BODY MIND BACK programme.

For more information and bookings, CLICK HERE